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Sacher SE, Neri JP, Gao MA, Argentieri EC, Potter HG, Koch KM, Koff MF. MAVRIC based T2 mapping assessment of infrapatellar fat pad scarring in patients with total knee arthroplasty. J Orthop Res 2023; 41:1299-1309. [PMID: 36262013 PMCID: PMC10113607 DOI: 10.1002/jor.25472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/06/2022] [Accepted: 10/18/2022] [Indexed: 02/04/2023]
Abstract
The infrapatellar fat pad (IPFP) has been implicated as a source of postoperative knee pain. Imaging the IPFP is challenging in patients with total knee arthroplasty (TKA) due to metallic susceptibility artifact. Multi-Acquisition Variable-Resonance Image Combination (MAVRIC)-based T2 Mapping has been developed to mitigate this artifact and can generate quantitative T2 data. Objectives of this study were to (1) measure T2 values of the IPFP in patients with TKAs using a MAVRIC based T2 mapping technique and (2) determine if IPFP T2 values are related to the degree of fat pad scarring or clinical magnetic resonance imaging (MRI) findings. Twenty-eight subjects (10 males, 18 females, Age: 66 + 7.2 years [Mean ± standard deviations]) undergoing clinical MRIs were sequentially recruited. Morphological imaging and quantitative T2 mapping sequences were performed on a clinical 1.5 T scanner. The morphologic images were graded for the presence and severity of fat pad scarring and clinical outcomes. T2 values were calculated in the total fat pad volume, a normal regions of interest (ROI), and an abnormal ROI. T2 values were shortened in the total IPFP volume (p = 0.001) and within abnormal regions (p = 0.003) in subjects with more severe IPFP scarring. The difference between T2 values in normal-abnormal regions was greater in subjects with severe versus no scarring (+1426.1%, p = 0.008). T2 values were elevated in patients with MRI findings of osteolysis (+32.3%, p = 0.02). These findings indicate that MAVRIC-based T2 Mapping may be used as a quantitative biomarker of postoperative IPFP scarring in individuals following TKA.
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Affiliation(s)
- Sara E. Sacher
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | - John P. Neri
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | - Madeleine A. Gao
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | | | - Hollis G. Potter
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | | | - Matthew F. Koff
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
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Taneja AK, Chhabra A. 2-Dimensional and 3-Dimensional MR Imaging-Aid to Knee Preservation Surgery: Focus on Meniscus and Articular Cartilage. Semin Ultrasound CT MR 2023. [DOI: 10.1053/j.sult.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Accart N, Dawson J, Obrecht M, Lambert C, Flueckiger M, Kreider J, Hatakeyama S, Richards PJ, Beckmann N. Degenerative joint disease induced by repeated intra-articular injections of monosodium urate crystals in rats as investigated by translational imaging. Sci Rep 2022; 12:157. [PMID: 34997110 PMCID: PMC8742129 DOI: 10.1038/s41598-021-04125-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/09/2021] [Indexed: 11/09/2022] Open
Abstract
The objective of this work was to assess the consequences of repeated intra-articular injection of monosodium urate (MSU) crystals with inflammasome priming by lipopolysaccharide (LPS) in order to simulate recurrent bouts of gout in rats. Translational imaging was applied to simultaneously detect and quantify injury in different areas of the knee joint. MSU/LPS induced joint swelling, synovial membrane thickening, fibrosis of the infrapatellar fat pad, tidemark breaching, and cartilage invasion by inflammatory cells. A higher sensitivity to mechanical stimulus was detected in paws of limbs receiving MSU/LPS compared to saline-injected limbs. In MSU/LPS-challenged joints, magnetic resonance imaging (MRI) revealed increased synovial fluid volume in the posterior region of the joint, alterations in the infrapatellar fat pad reflecting a progressive decrease of fat volume and fibrosis formation, and a significant increase in the relaxation time T2 in femoral cartilage, consistent with a reduction of proteoglycan content. MRI also showed cyst formation in the tibia, femur remodeling, and T2 reductions in extensor muscles consistent with fibrosis development. Repeated intra-articular MSU/LPS injections in the rat knee joint induced pathology in multiple tissues and may be a useful means to investigate the relationship between urate crystal deposition and the development of degenerative joint disease.
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Affiliation(s)
- Nathalie Accart
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Janet Dawson
- Autoimmunity, Transplantation & Inflammation Department, Novartis Institutes for BioMedical Research, Lichtstr. 35, WSJ-386.6.08.18, CH-4056, Basel, Switzerland
| | - Michael Obrecht
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Christian Lambert
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Manuela Flueckiger
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Julie Kreider
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Shinji Hatakeyama
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Peter J Richards
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland
| | - Nicolau Beckmann
- Musculoskeletal Diseases Department, Novartis Institutes for BioMedical Research, Fabrikstr. 28.3.04, CH-4056, Basel, Switzerland.
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Nikiforaki K, Ioannidis GS, Lagoudaki E, Manikis GH, de Bree E, Karantanas A, Maris TG, Marias K. Multiexponential T2 relaxometry of benign and malignant adipocytic tumours. Eur Radiol Exp 2020; 4:45. [PMID: 32743728 PMCID: PMC7396415 DOI: 10.1186/s41747-020-00175-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background We investigated a recently proposed multiexponential (Mexp) fitting method applied to T2 relaxometry magnetic resonance imaging (MRI) data of benign and malignant adipocytic tumours and healthy subcutaneous fat. We studied the T2 distributions of the different tissue types and calculated statistical metrics to differentiate benign and malignant tumours. Methods Twenty-four patients with primary benign and malignant adipocytic tumours prospectively underwent 1.5-T MRI with a single-slice T2 relaxometry (Carr-Purcell-Meiboom-Gill sequence, 25 echoes) prior to surgical excision and histopathological assessment. The proposed method adaptively chooses a monoexponential or biexponential model on a voxel basis based on the adjusted R2 goodness of fit criterion. Linear regression was applied on the statistical metrics derived from the T2 distributions for the classification. Results Healthy subcutaneous fat and benign lipoma were better described by biexponential fitting with a monoexponential and biexponential prevalence of 0.0/100% and 0.2/99.8% respectively. Well-differentiated liposarcomas exhibit 17.6% monoexponential and 82.4% biexponential behaviour, while more aggressive liposarcomas show larger degree of monoexponential behaviour. The monoexponential/biexponential prevalence was 47.6/52.4% for myxoid tumours, 52.8/47.2% for poorly differentiated parts of dedifferentiated liposarcomas, and 24.9/75.1% pleomorphic liposarcomas. The percentage monoexponential or biexponential model prevalence per patient was the best classifier distinguishing between malignant and benign adipocytic tumours with a 0.81 sensitivity and a 1.00 specificity. Conclusions Healthy adipose tissue and benign lipomas showed a pure biexponential behaviour with similar T2 distributions, while decreased adipocytic cell differentiation characterising aggressive neoplasms was associated with an increased rate of monoexponential decay curves, opening a perspective adipocytic tumour classification.
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Affiliation(s)
- Katerina Nikiforaki
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece. .,Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece.
| | - Georgios S Ioannidis
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece
| | - Eleni Lagoudaki
- Department of Pathology, University Hospital of Crete, Heraklion, Greece
| | - Georgios H Manikis
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece
| | - Eelco de Bree
- Department of Surgical Oncology, University Hospital of Crete, Heraklion, Greece
| | - Apostolos Karantanas
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece.,Department of Medical Imaging, University Hospital, Heraklion, Greece
| | - Thomas G Maris
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece.,Department of Radiology, School of Medicine, University of Crete, Heraklion, Greece.,Department of Medical Physics, University of Crete, Heraklion, Greece
| | - Kostas Marias
- Computational Bio-Medicine Laboratory (CBML), Institute of Computer Science (ICS), Foundation for Research and Technology - Hellas (FORTH), Nikolaou Plastira 100, Vassilika Vouton, GR-70013, Heraklion, Crete, Greece.,Department of Electrical & Computer Engineering, Hellenic Mediterranean University, Heraklion, Greece
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Ioannidis GS, Nikiforaki K, Kalaitzakis G, Karantanas A, Marias K, Maris TG. Inverse Laplace transform and multiexponential fitting analysis of T2 relaxometry data: a phantom study with aqueous and fat containing samples. Eur Radiol Exp 2020; 4:28. [PMID: 32378090 PMCID: PMC7203287 DOI: 10.1186/s41747-020-00154-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The inverse Laplace transform (ILT) is the most widely used method for T2 relaxometry data analysis. This study examines the qualitative agreement of ILT and a proposed multiexponential (Mexp method) regarding the number of T2 components. We performed a feasibility study for the voxelwise characterisation of heterogeneous tissue with T2 relaxometry. METHODS Eleven samples of aqueous, fatty and mixed composition were analysed using ILT and Mexp. The phantom was imaged using a 1.5-T system with a single slice T2 relaxometry 25-echo Carr-Purcell-Meiboom-Gill sequence in order to obtain the T2 decay curve with 25 equidistant echo times. The adjusted R2 goodness of fit criterion was used to determine the number of T2 components using the Mexp method on a voxel-based analysis. Comparison of mean and standard deviation of T2 values for both methods was performed by fitting a Gaussian function to the ILT resulting vector. RESULTS Phantom results showed pure monoexponential decay for acetone and water and pure biexponential behaviour for corn oil, egg yolk, and 35% fat milk cream, while mixtures of egg whites and yolks as well as milk creams with 12-20% fatty composition exhibit mixed monoexponential and biexponential behaviour at different fractions. The number of T2 components by the Mexp method was compared to the ILT-derived spectrum as ground truth. CONCLUSIONS Mexp analysis with the adjusted R2 criterion can be used for the detection of the T2 distribution of aqueous, fatty and mixed samples with the added advantage of voxelwise mapping.
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Affiliation(s)
- Georgios S Ioannidis
- Foundation for Research and Technology-Hellas (FORTH), Institute of Computer Science (ICS), Computational Bio-Medicine Laboratory (CBML), N.Plastira 100, Vassilika Vouton, Heraklion, GR-70013, Crete, Greece. .,School of Medicine, University of Crete, Heraklion, Greece.
| | - Katerina Nikiforaki
- Foundation for Research and Technology-Hellas (FORTH), Institute of Computer Science (ICS), Computational Bio-Medicine Laboratory (CBML), N.Plastira 100, Vassilika Vouton, Heraklion, GR-70013, Crete, Greece.,School of Medicine, University of Crete, Heraklion, Greece
| | - Georgios Kalaitzakis
- School of Medicine, University of Crete, Heraklion, Greece.,Department of Medical Physics, University of Crete, Heraklion, Greece
| | - Apostolos Karantanas
- Foundation for Research and Technology-Hellas (FORTH), Institute of Computer Science (ICS), Computational Bio-Medicine Laboratory (CBML), N.Plastira 100, Vassilika Vouton, Heraklion, GR-70013, Crete, Greece.,School of Medicine, University of Crete, Heraklion, Greece.,Department of Medical Imaging, University Hospital, Heraklion, Greece
| | - Kostas Marias
- Foundation for Research and Technology-Hellas (FORTH), Institute of Computer Science (ICS), Computational Bio-Medicine Laboratory (CBML), N.Plastira 100, Vassilika Vouton, Heraklion, GR-70013, Crete, Greece.,Department of Electrical & Computer Engineering, Hellenic Mediterranean University, Heraklion, Greece
| | - Thomas G Maris
- Foundation for Research and Technology-Hellas (FORTH), Institute of Computer Science (ICS), Computational Bio-Medicine Laboratory (CBML), N.Plastira 100, Vassilika Vouton, Heraklion, GR-70013, Crete, Greece.,School of Medicine, University of Crete, Heraklion, Greece.,Department of Medical Physics, University of Crete, Heraklion, Greece
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Infrapatellar fat pad aggravates degeneration of acute traumatized cartilage: a possible role for interleukin-6. Osteoarthritis Cartilage 2017; 25:138-145. [PMID: 27616684 DOI: 10.1016/j.joca.2016.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/19/2016] [Accepted: 09/01/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The infrapatellar fat pad (IPFP), which is located underneath the patella, close to cartilage surfaces, functions in distributing mechanical load and has been shown to produce cytokines. This study aims to assess the involvement of the IPFP in the progression of post-traumatic osteoarthritis (OA) through investigating the crosstalk between the IPFP and injured cartilage in vitro. METHODS A single blunt impact (36 MPa) on healthy bovine articular cartilage explants was used to generate traumatized cartilage. Conditioned media from IPFP and traumatized cartilage (FP-CM and TC-CM) were prepared separately. After culturing in FP-CM, the posttraumatic cartilage explants were analyzed for expression of cartilage degeneration associated genes and secretion of the interleukin (IL)-6, into the culture medium. The effect of traumatized cartilage on IPFP was studied by treating IPFP-derived adipocytes and IPFP adipose-derived stromal cells (ADSC) with TC-CM followed by analysis of cytokine expression. RESULTS FP-CM aggravated glycosaminoglycan (GAG) release in traumatized cartilage, but did not significantly affect healthy cartilage. FP-CM raised gene expression of cyclooxygenase-2, inducible nitric oxide synthase, and IL-6 in traumatized cartilage explants, and lowered expression of tissue inhibitor of metalloproteinases-1, 2, 3, compared to non-conditioned medium. Of particular significance is that medium IL-6 levels increased substantially in both FP-CM and FP-CM treated traumatized cartilage cultures. Extrinsic IL-6 treatment of traumatized cartilage simulated part of the effects of FP-CM. TC-CM elevated levels of IL-6 expression in IPFP derived adipocytes and ADSCs. CONCLUSIONS IPFP aggravates post-traumatized cartilage degeneration, and IL-6 is a candidate tissue degeneration mediator.
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